Are you legally eligable for employment in this country?Proof of citizenship or immigration status will be requested upon employment.

YesNo

Are you able to meet the attendance requirments for this position?

YesNo

Are you willing to work overtime if requested?

YesNo

Have you ever been bonded?

YesNo

Have you ever been arrested or convicted of a crime that has not been expunged by a court?

YesNo

Please give us more details:Write as much as you need, there's no character limit here.

0 /

Do you have any physical limitations that would prevent you from lifting, pulling, pushing, and/or bending over to pick up an object?pick one!

YesNo

Please give us more details:Write as much as you need, there's no character limit here.

0 /

Have you ever been put on a weight restriction for lifting?

YesNo

Please give us more details:Write as much as you need, there's no character limit here.

0 /

Employment Desired

Position Desiredpick one!

Which position?

Locationpick one!

Start DateWhen can you start?

How did you hear about this opening?pick one!

Mind telling us who?Employee's Name

Mind telling us how?

Are you currently employed?

YesNo

Have you ever applied to Dream Team: Family Supports before?

YesNo

Please summarize your weekly availability (including Sunday, Saturday):Write as much as you need, there's no character limit here.

0 /

Education, Training, & Skills

Highest Level of Education Completedpick one!

Do you have any special training and/or skills you'd like us to be aware of?Subjects of special study/research or special training/skills:

0 /

Have you served in the military?pick one!

YesNo

Employment History

Please fill this section out from most recent to least recent.

Employer 1

Employer Name/Company Name

Start Date

End Date

Salary/Wage

Position

Reason for Leaving

May we contact them as a reference?pick one!

Employer 2

Employer Name/Company Name

Start Date

End Date

Salary/Wage

Position

Reason for Leaving

May we contact them as a reference?pick one!

Employer 3

Employer Name/Company Name

Start Date

End Date

Salary/Wage

Position

Reason for Leaving

May we contact them as a reference?pick one!

Please explain any gaps in employment:Write as much as you need, there's no character limit here.

0 /

Criminal Background Check Authorization

In consideration for potential employment and/or employment with The Dream Team: Family Supports, L.L.C. ("Employer"), Employer will make or will cause an agency on its behalf to make inquiries, including but limited to, criminal history, abuse registry, professional licensure (ie nurse reg) public records, experience, or other qualifications for employment, including reasons for termination of past employment.

Please complete and sign below to authorize, without reservation, any party, including, but not limited to, employers, law enforcement agencies, state agencies, county agencies, institutions and private information bureaus or repositories, contacted by Employer and its agent from any and all liability for damages arising from the investigation and disclosure of the requested informatino. Further, it releases and discharges all liability from all companies, agencies, officials, officers, employees and other persons, who, in good faith, provide to us the above-mentioned information as requested, in order to successfully complete a background investigation.

Nameyour full name

Date of Birth

Sex

Race

Social Security Number

By checking the box below, I acknowledge and understand that typing my name in the E-Signature box on this page constitutes my legal signature and is legally binding as such:

YesNo

E-Signaturetype your full name:

*Date of birth, sex, and race are being requested solely for the purposes of identification in obtaining accurate retrieval of records and will not be used for discriminatory purpose.

References & Submission of Application

Please give the names of three individuals, not related to you, whom have known you for at least one year:

Reference 1

Nametheir full name

Phone Number

Years Known

How do you know this individual?pick one!

You selected "Other," please give us more details:

Reference 2

Nametheir full name

Phone Number

Years Known

How do you know this individual?pick one!

You selected "Other," please give us more details:

Reference 3

Nametheir full name

Phone Number

Years Known

How do you know this individual?pick one!

You selected "Other," please give us more details:your full name

If you would like to upload your resume, you can do so by clicking the button below:

Upload

By using my E-Signature below clicking the submit button, I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employement for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. This online application does not permit the release or use of disability-related or medical information in a manner prohibited by the American with Disabilities Act (ADA) and other relevant federal and state laws. By utilizing my E-Signature below, I affirm that I have read and understand this document.